GINGIVECTOMY

HERRINA FIRMANTINI
 DEFINITION
The word gingivectomy means
excision of the gingiva. By
removing the pocket wall,
gingivectomy provides visibility and
accessibility for complete calculus
removal and the thoroughsmoothing
of the roots
 INDICATION
1. Elimination of suprabony pockets,
regardless of their depth, if the
pocket wall is fibrous and firm
2. Elimination of gingival enlargements
3. Elimination of suprabony periodontal
abscesses
 CONTRA INDICATION
1. The need for bone surgery or
examination of the bone shape and
morphology
2. Situations in which the bottom of
the pocket is apical to the
mucogingival junction
3. Aesthetic considerations,
particularly in the anterior maxilla
TECHNIQUE
STEP 1
STEP 2
STEP 2
KIRKLAND KNIFE
APPLICATION
ORBAN KNIFE APPLICATION
DEBRIDEMENT
DRESSING APPLICATION
 GINGIVOPLASTY
Gingivectomy is performed to
eliminate periodontal pockets, and it
includes reshaping as part of the
technique.
Gingivoplasty is a reshaping of the
gingiva to create physiologic gingival
contours with the sole purpose of
recontouring the gingiva in the
absence of pockets.
 TECHNIQUE
Gingivoplasty may be accomplished
with a periodontal knife, a scalpel,
rotary coarse diamond stones, or
electrodes.
 The technique resembles that of the
festooning of an artificial denture,
which consists :
a. Of tapering the gingival margin
b. Creating a scalloped marginal
outline
c. Thinning the attached gingiva
d. Creating vertical interdental grooves
e. Shaping the interdental papillae.
 HEALING AFTER SURGICAL
GINGIVECTOMY
The initial response after
gingivectomy is the formation of a
protective surface blood clot.
In 24 hours, there is an increase in
new connective tissue cells, which
are mainly angioblasts beneath the
surface layer of inflammation and
necrotic tissue
By the third day, numerous young
fibroblasts are located in the area
 2 weeks, they connect with the
gingival vessels
After 12 to 24 hours, epithelial cells
at the margins of the wound begin to
migrate over the granulation tissue,
thereby separating it from the
contaminated surface layer of the
clot
 Epithelial activity at the margins
reaches a peak after 24 to 36 hours
After 5 to 14 days, surface
epithelialization is generally
complete
During the first 4 weeks after
gingivectomy, keratinization is less
than it was before surgery
Complete epithelial repair takes
about 1 month
 Vasodilation and vascularity begin to
decrease after the fourth day of
healing, and they appear to be
almost normal by the sixteenth
day.36 Complete repair of the
connective tissue takes about 7
weeks
TERIMA KASIH